Orissa

Rayagada

CC/175/2016

G. Rajeswarin - Complainant(s)

Versus

The Manager, Bajaj Allianz Life Insurance - Opp.Party(s)

Self

29 Aug 2018

ORDER

DISTRICT   CONSUMER  DISPUTES REDRESSAL    FORUM, RAYAGADA,

STATE:  ODISHA.

C.C. Case  No. 175/ 2016.                                        Date.      .    8    . 2018.

P R E S E N T .

Dr. Aswini  Kumar Mohapatra,                                      President

Sri  Gadadhara  Sahu,                                                       Member.

Smt.  Padmalaya  Mishra,.                                              Member

 

Sri  G. Rajeswari, W/O: G.Kabiraj Rao,  AT:Aurobindo Nagar,    Po/ DIST: Rayagada, State:  Odisha,  PIN No. 765 001, Cell No. 8018458134 .

                                                                                                            ……Complainant.

Versus.

1.The Branch Manager,  Bajaj Allianz life insurance company Ltd., Rayagada.

2.D.Chethana, R.P. Rao, Asst. Manager,(Operations), Bajaj Allianz life insurance company Ltd, Rayagada.

3.STM-Kiran Kumar, code No. 1100143420.

4.ICC-Smita Kumari  Patro, code No. 1000324551.

5.The General Manager, Bajaj Allinz, Life Insurance Company Ltd., GE Plaza, Airport Road, Yerawada,Pune.

                                                                                                            …Opposite parties.           

For the Complainant:-Self..

For the O.Ps:- SriV. Avatar, Advocate, Rayagada.

JUDGEMENT.

       The  curx of the case is that  the above named complainant alleging deficiency in service  against  afore mentioned O.Ps for  non payment of Rs.60,000/- towards policy No. 0035105932 for which  the complainant  sought for redressal of the grievances raised by the complainant.

On being noticed  the learned counsel for the O.Ps    filed written version inter alia  challenged  the maintainability of the  petition before the forum. The averments made in the  petition are  all false, and O.Ps     deny   each and every allegation made in the petition. The O.Ps   taking one  & other grounds in the written version   sought to dismiss the complaint as it is not maintainable  under the C.P. Act, 1986.  The O.Ps.      prays the forum to dismiss the complaint petition  for the best interest of justice.

 

The O.Ps   appeared and defend the case.  Heard arguments from the  learned counsel for  the  O.Ps   and from the complainant.    Perused the record, documents,  written version filed by the parties. 

This forum  examined the entire material on record  and given  a thoughtful consideration  to the  arguments  advanced  before us by  the  parties touching the points both on the facts  as well as on  law                                           

                                                                                  FINDINGS.

 

On perusal of the record it is revealed that there is no dispute that the complainant was a policy holder bearing No. 0035105932  opted for unit linked policy namely product capital unit Gain.   Further  there is no disputes the  above  policy  term and premium payment term   is 20 years.   Again  there is no dispute the complainant had  paid total amount a sum Rs. 30,000/-  dates mentioned  Dt.5.1.2007, Dt.4.2.2008, Dt.13.9.2010 towards  03  Nos.  yearly  premium  @ Rs. 10,000/- each premium. (copies of the deposit slip is in the file marked as  Annexure-I to Annexure-III).  

The O.Ps in their written version contended that   the complainant was required to pay the yearly premiums @ Rs. 10,000/- for premium paying term of 20 years but she did not pay the yearly regular premiums due falls  on Dt.05.01.2011 and onwards. The policy stands surrendered strictly in accordance with the terms and conditions  of the policy. The complainant  has also enjoyed the risk cover for a period of 3 years from commencement of the policy.

 The main grievance of the complainant is that  he had deposited  3  Nos. of annual premium  on Dt.5.1.2007,  Dt. 4.2.2008, Dt. 13.9.2010 respectively total amount a sum of Rs.30,000/-.The complainant has  submitted  in her  petition that   the O.Ps assured the complainant after depositing  the above amount  on completion  of three years, she will get double amount  i.e. Rs.60,000/-.. When the O.Ps  have not disbursed the above assured amount on completion of three years   she filed C.C. petition before the forum to get the above amount.

         

 

          .        

 Again the O.Ps have  argued  that the allegation of the complainant regarding to  get double amount  i.e. Rs.60,000/- from the O.Ps are  groundless and against the policy terms and  conditions,.

             Afore-mentioned facts establish  that nothing  is either  due or legally recoverable by the complainant from the O.Ps and O.Ps have duly complied with the terms and conditions of the policy  contract.  In the ligjht of above facts and contract no cause of action ever arose against  the O.Ps as the present  complaint does not  raise any “Consumer Dispute” and there is no deficiency  on the part of the O.Ps.  The  complainant  has neither a legal  basis nor a  valid cause of action  against the O.Ps to file the present complaint before the  forum. Hence this forum has not  warranted to interfere in to  the present complaint. That the modus operandi of the O.Ps  is different from any insurance sectors and it earnestly follows the rules and  regulations passed by the IRDA and further  functions of its business are carried in accordance with the settled principles of law.  The grievances of the complaint is unworthy of credence.

          This  forum relied  citation.  It is held and reported in C.P.R-2011((4) Page No. 86 the Hon’ble State C.D.R.Commission, Chandigarh where in  observed “Unit linked schemes cannot bring any fixed amount to investors”.

          This forum further observed  that the policy namely  Unit Gain Plus which was issued  in favour of the complainant, was directly related with the share  market and because of economic melt down  in the International  market, which also adversely affected the share market of India, price of shares of even  big  companies fell down. Similarly, the price of units issued  to the complainant , under  the  policy, in question, also reduced, which was  not   under the control of any particular individual. More over, the  unit price fluctuates day by day and sometimes it goes up and sometimes it becomes very low. Due to instability in the market, it can not  be said what would be the rate of unit at the time of  surrender by the complainant, if he choses so. Again this forum observed  In fact, the original policy bond was with the  complainant, it was mentioned that the policy was related  to the share market.  As per the terms and conditions of the policy, 15 days time was given to the complainant, which is known  as “Free Look period” as per the guidelines of IRDA and if he want to say anything  with  regard to the terms and conditions, and if those were not  acceptable to him, he could ask for the cancellation of the policy but the complainant failed to exercise that option.

         

          Again  another citation cited by this forum.  It is held and reported  in 1999(6) SCC 451 in the cases The oriental Insurance Co. Ltd  Vrs. Sony   Cheriyan where in the Hon’ble Supreme Court  observed  “The insurance policy between the insurer and the insured represents a contract between the parties. Since the  insurer undertakes to compensate the loss suffered  by the insured  on account of risks covered by the insurance policy, the terms of the agreement have to be strictly construed to determine the extent of liability   of the insurer. The insured  can not claim any thing more than what is covered by the  insurance policy”.

          Similarly in the case of General Assurance Societ Ltd. Vrs. Chandumull Jain and Anr. Reported in  1966 (3) SCR 500 the Constitution Bench            has observed that the policy  document being a contract and it has to be read strictly. It  was observed “In interpreting documents relating to a contract of insurance, the duty of the court it to interpret the words in which the contract is expressed  by the parties, because  it is not for the court to make a new contract, however reasonable, if the parties have not make it themselves.

Again this forum observed the  O.Ps disputes and deny their liability to pay double amount and compensation to the complainant  as alleged..   It is stated that policy is a legal contract between the policy holder and the insurance  company and the parties to the said contract are bound by its terms and conditions. That the terms of the policy are in the nature of the contract and their interpretation has to be made in accordance with the strict construction of the contract.  Thus, the words in an insurance contract must be given paramount importance and interpreted as expressed without any addition, deletion of substitution,  more so when the parties have already accepted and acted  on the same.  The law in this regard is very well settled and one may  conveniently referred to recent judgement of the  Hon’ble Apex Court in case of Surajmal Ram Niwas Oil Mills Pvt. Ltd. Vrs. United India Insurance Company Ltd. Reported in 2010(10) SCC 567,  the same has clearly stated in the case of  Reliance Life Insurance Company Ltd. Vrs. Madhavacharya (Revision  petition No. 211 of 2009),  wherein it was held by the Hon’ble  National Commission  observed  “That since the insurance between the insurer and the  insured is a contract between  the parties, the terms  of the agreement including applicability    of the provisions and also to its exclusion had to be strictly construed to determine the extent of the liability of the insurer.

Further It is held and reported in  2008(4) CPJ 157 in the case of  Life Insurance Corporation of India Vrs. Shiva Prasad Das and others where in the Hon’ble National Commission observed “The premium is given  by an insured, to cover the risk  for a given period, and the insurer covers the risk for the period for which the premium  has been paid.  It is not the case of the complainant that the risk was not covered for the period for which the premium was given. If after that the policy  lapsed, under no provision of terms of policy or law, could any for a  direct  for  refund of any premium for the simple reason, as already  started, that the risk stood covered for the period for which premium had been paid.”

The Hon’ble State C.D.R.Commission,Cuttack, Odisha  in F.A. No. 162/2010  in the case of Smt. Abanti Kumar Sahu Vrs. Bajaj Allianz ) where in observed “ In as much as the policy   which was invested in the share market which is no doubt a speculative gain. The speculative  investment matter does not come under the C.P. Act, 1986.  Since the funds of this policy are also invested in the share market which is subject to speculations.”

The O.P. in their written version contended that the complainant was explained that the money  she invested with them in form of policy, depends  on the terms and conditions of the policy. On the basis of profits from the market, the policy holders, shall get their  share in the form of premium. As per the policy structure of the complainant, if any,  the  O.Ps have ready to comply by paying her actual dues if at all she is entitled and the O.Ps  shall not owe any further liability to the complainant   if it is already settled.

          It is pertinent  to note  here  that the pay out form clearly mentioned the terms and conditions stating that the surrender amount of the said policy will be payable after deduction of the allocation charges based on the effective NAV rates and also total  surrender amount will be payable to the complainant.

This forum  completely agreed with views taken by the O.Ps in their written version inter alia  the documents filed by the O.Ps in  the present case.  Hence  this forum  found  the complainant is  entitled only N.A.V/surrender value of the above  policy.

To meet the ends of justice the following order is passed.

ORDER.

In  resultant the complaint petition stands  allowed in part against the O.Ps.

The O.Ps are directed to pay  the amount deposited by the complainant along with  interest @ 9% per annum from date of filing  of this case i.e. on  Dt.31.05.2016 till  realisation  towards  the policy No. 0035105932 to the complainant  within  one month of dispatch of this order.

Parties are left to bear their own cost.    Accordingly the case  is disposed of.

Dictated and corrected by me.              

Pronounced on this                ^th.   Day of   August,  2018.

 

 

 

Member.                                             Member.                                                                             President